Document Type : Original article
Authors
1 Department of computer and Information technology, Payame Noor University, Tehran, Iran
2 corresponding author, Assistant Professor, Department of Psychology, Payame Noor University, Tehran, Iran
3 Department of Psychology, Payame Noor University, Tehran, Iran
4 MD,General Surgery Board,Aesthetic Surgery
Abstract
Introduction:Many studies have shown that borderline personality disorder is related to the neuropsychological deficits and there is also evidence that neurocognitive profile of patients with borderline personality disorder can be related to the consequences of this disorder. This study aimed to Examining the efficacy treatment of Computer-based Neurocognitive in people with borderline personality disorder. Method: this study's design was pre experimental with pretest- posttest. Studied population consisted of all patient with borderline personality disorder who were visited in clinics and health centers in Tehran. The sample included 30 patients who met the Diagnostic Interview for Borderline Personality Disorder—Revised version (DIB-R) criteria in the 4 scale affective dysregulation, impulse action patterns, cognitive– perceptual impairment and interpersonal relationship disturbance for borderline personality disorder. Patients were randomly assigned in experimental and control groups ( 15 patients in experimental group and 15 patient in control group), then therapeutic interventions were made. Subjects were also assessed by clinical, neuropsychological and functional measures in baseline and after 32 meet of the 16Weeks of computer-assisted cognitive remediation (experimental group) intervention or treatment as usual (control group) which were made twice a week. Findings: Covariance analysis results demonstrated that patients who received CACR showed greater improvement in working memory and psychosocial functioning results than patients treated with TAU, but symptom severity didn't have significant difference. Conclusion: Findings of this study showed the feasibility and potential the efficacy treatment of Computer-based Neurocognitive domains, suggesting a relatively limited clinical usefulness of the treatment of Computer-based Neurocognitive in the treatment of the borderline personality disorder.
Keywords
برکتین، مجید ؛ توکلی، ماهگل ؛ مولوی، حسین ؛ معروفی، محسن و صالحی، مهرداد.(1386). هنجاریابی، اعتبار و روایی مقیاس سنجش مانیای یانگ،روانشناسی، سال یازدهم، شماره11،166-150
تهرانی دوست، م.؛ آزادی، ب.؛ صدیق، ا.؛ اشرفی، م. و علاقبندراد، ج.(1384). اختلال کارکردهای اجرایی در بیماران مبتلا به فنیل کتونوری درمان شده.تازه های علوم شناختی. 7 (1)، 9-1.
محمدخانی، پروانه؛ جهانی تابش، عذرا؛ تمنایی فر، شیما.(1384).مصاحبه بالینی ساختار یافته برای اختلالات DSM-IV-TR ، تهران: انتشارات فرادید.
Amad, A., Ramoz, N., Thomas, P., Jardri, R., & Gorwood, P. (2014). Genetics of borderline personality disorder: Systematic review and proposal of an integrative model. Neuroscience & Biobehavioral Reviews, 40, 6-19.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. 4th ed.,Text Revision. Washington, DC: American Psychiatric Association.
American Psychiatric, A., American Psychiatric, A., & Force, D. S. M. T. (2013). Diagnostic and statistical manual of mental disorders : DSM-5.Retrieved from http://dsm.psychiatryonline.org/book.aspx? Booki d=556.
Anaya, C., Martinez Aran, A., Ayuso-Mateos, J. L., Wykes, T., Vieta, E., & Scott, J. (2012). A systematic review of cognitive remediation for schizo-affective and affective disorders. Journal of Affective Disorders, 142(1), 13–21.
Arza, R., Diaz-Marsa, M., López-Micó, C., de Pablo, N. F., López-Ibor, J. J., & Carrasco, J. L. (2009a).Neuropsychological dysfunctions in personality borderline disorder: Detection strategies. Actas Espanolas de Psiquiatria, 37(4), 185–190.
Arza, R., Díaz-Marsá, M., López-Micó, C., de Pablo, N. F., López-Ibor, J. J., & Carrasco, J. L. (2009b).Neuropsychological rehabilitation in patients with borderline personality disorder: A case series.Actas Espanolas de Psiquiatria, 37(4), 236–239.
Assessing the contribution of borderline personality disorder and features to suicide risk in psychiatric inpatients with bipolar disorder,major depression and schizoaffective disorder. Psychiatry Research, 226(1), 361-367.
Barlati, S., Deste, G., DePeri, L., Ariu, C., & Vita, A. (2013). Cognitive remediation in schizophrenia: Current status and future perspectives. Schizophrenia Research and Treatment, 2013, 1–12. Epub 2013 Dec 17.
Bender, D. S., Dolan, R. T., Skodol, A. E., Sanislow, C. A., Dyck, I. R., McGlashan, T. H.,…Gunderson, J. G.(2001). Treatment utilization by patients with personality disorders. American Journal of Psychiatry,158(2), 295–302.
Binks, C. A., Fenton, M., McCarthy, L., Lee, T., Adams, C. E., & Duggan, C. (2006). Pharmacological interventions for people with borderline personality disorder. Cochrane Database of Systematic Review, 25(1),CD005653.
Blacker, D. (2005). Psychiatric rating scales. In: B. Sadock & V. Sadock (Eds.). Kaplan & Sadocks Comprehensive Textbook of Psychiatry. Lippincott Williams, Philadelphia,933-945.
Cheung, A. M., Mitsis, E. M., & Halperin, J. M. (2004). The relationship of behavioral inhibition to executive functions in young adults. Journal of Clinical and Experimental Neuropsychology, 26(3), 393–404.
Depp, C. A., Mausbach, B. T., Harmell, A. L., Savla, G. N., Bowie, C. R., Harvey, P. D., & Patterson, T. L. (2012).Meta-analysis of the association between cognitive abilities and everyday functioning in bipolar disorder.Bipolar Disorders, 14(3), 217–226.
Derogatis L. R., Rickels K., Rock A. F.(1976).The SCL-90 and the MMPI—A step in the validation of a new self-report scale. Br. J.Psychiatry, 128: 280–289.
Derogatis, L. R.( 2000). Symptom Checklist-90- Revised. in Handbook of psychiatric measures.American Psychiatric Association, 81-84.
Dubovsky, A. N., & Kiefer, M. M. (2014). Borderline Personality Disorder in the Primary Care Setting. Medical Clinics of North America, 98(5), 1049- 1064.
Fertuck, E. A., Keilp, J., Song, I., Morris, M. C., Wilson, S. T., Brodsky, B. S., & Stanley, B. (2012). Higher executive control and visual memory performance predict treatment completion in borderline personality disorder. Psychotherapy and Psychosomatics, 81(1), 38–43.
Fertuck, E. A., Lenzenweger, M. F., Clarkin, J. F., Hoermann, S., & Stanley, B. (2006). Executive neurocognition, memory systems, and borderline personality disorder. Clinical Psychology Review, 26(3), 346–375.
Fett, A. K., Viechtbauer, W., Dominguez, M. D., Penn, D. L., van Os, J., & Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: A meta-analysis. Neuroscience and Biobehavioral Reviews, 35(3), 573–588.
Fornaro, M., Orsolini, L., Marini, S., De Berardis, D., Perna, G., Valchera, A., Stubbs, B. (2016). The prevalence and predictors of bipolar and borderline personality disorders comorbidity Systematic review and meta-analysis. Journal of Affective Disord, 195, 105-118.
Grynszpan, O., Perbal, S., Pelissolo, A., Fossati, P., Jouvent, R., Dubal, S., & Perez-Diaz, F. (2011). Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: A meta-analytical study. Psychological Medicine, 41(1), 163–173.
Gunderson, J.G. (2011). Borderline personality disorder. New England Journal of Medicine, 364: 2037- 41.
Gvirts, H. Z., Harari, H., Braw, Y., Shefet, D., Shamay-Tsoory, S. G., & Levkovitz, Y. (2012). Executive functioning among patients with borderline personality disorder (BPD) and their relatives. Journal of Affective Disorders, 143(1–3), 261–264.
Haaland, V. Ø., Esperaas, L., & Landrø, N. I. (2009). Selective deficit in executive functioning among patients with borderline personality disorder. Psychological Medicine, 39(10), 1733–1743.
Hilsenroth, M. J., Ackerman, S. J., Blagys, M. D., Baumann,B. D., Baity, M. R., Smith, S. R., Price, J. L., Smith, C.L., Heindselman, T. L., Mount, M. K., & Holdwick, D.J. (2000). Reliability and validity of DSM-IV axis V.American Journal of Psychiatry, 157, 1858-1863.
Kernberg, O. F., & Michels, R. (2009). Borderline personality disorder. American Journal of Psychiatry, 166(5), 505–508.
Kohling, J., Ehrenthal, J. C., Levy, K. N., Schauenburg, H., & Dinger, U. (2015). Quality and severity of depression in borderline personality disorder: A systematic review and meta-analysis. Clinical Psychological Review, 37, 13-25.
Leathem, J.M., & Babbage, D.R .( 2000).Affective disorders after traumatic brain injury:cautions in the use of the Symptom Checklist-90-R.J Head Trauma Rehabil., 15(6), 1246-1255.
LeGris, J., & van Reekum, R. (2006). The neuropsychological correlates of borderline personality disorder and suicidal behaviour. Canadian Journal of Psychiatry, 51(3), 131–142.
Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74-84.
Lezak, M.D. (2004). "Neuropsychological Assessment". 4e: Oxford University Press, USA.
Lindenmayer,J.P., McGurk,S.R., Khan,A., Kaushik, S., Thanju,A., Hoffman,L.,Valdez,G., Wance,D., Herrmann,E.(2013); Improving Social Cognition in Schizophrenia: A Pilot Intervention Combining Computerized Social Cognition Training With Cognitive Remediation, Schizophrenia Bulletin, 39( 3), 507–517.http://www.markersoftware.com/USA/frames.htm.
Lobbestael, J., & Arntz, A. (2015). Emotional hyperreactivity in response to childhood abuse by primary caregivers in patients with borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 48, 125- 132.
Lora, A., Bai, G., Bianchi, S., Bolongaro, G., Civenti, G., & Erlicher, A. (2001). La versione italiana della HoNOS (Health of the Nation Outcome Scales), una scala per la valutazione della gravità e dell’esito nei servizi di salute mentale. Epidemiologia e Psichiatria Sociale, 10(3), 198–204.
Martín-Blanco, A., Soler, J., Villalta, L., Feliu-Soler, A., Elices, M., Pérez, V., . . . Pascual, J. C. (2014). Exploring the interaction between childhood maltreatment and temperamental traits on the severity of borderline personality disorder.Comprehensive Psychiatry, 55(2), 311-318.
Nakar, O., Brunner, R., Schilling, O., Chanen, A., Fischer, G., Parzer, P., Kaess, M. (2016). Developmental trajectories of self-injurious behavior, suicidal behavior and substance misuse and their association with adolescent borderline personality pathology. Journal of Affective Disorders, 197, 231-238.
Nosè, M., Cipriani, A., Biancosino, B., Grassi, L., & Barbui, C. (2006). Efficacy of pharmacotherapy against core traits of borderline personality disorder: Meta-analysis of randomized controlled trials.International Clinical Psychopharmacology, 21(6), 345–353.
Oldham, J. M. (2005). Guideline watch: Practice guideline for the treatment of patients with borderline personality disorder. Arlington, VA: American Psychiatric Association.
Oldham, J. M. (2006). Borderline personality disorder and suicidality. American Journal of Psychiatry,163(1), 20-26.
Parker, G., O’Donnell, M., Hadzi-Pavlovic, D., & Proberts, M. (2002). Assessing outcome in community mental health patients: A comparative analysis of measures. International Journal of Social Psychiatry, 48(1), 11–19.
Petrides, M., & Milner, B. (1982). Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man. Neuropsychologia, 20(3), 249–262.
Pirkis, J. E., Burgess, P. M., Kirk, P. K., Dodson, S., Coombs, T. J., & Williamson, M. K. (2005, November 28). A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures. Health and Quality of Life Outcomes, 3, 76.
Reeder, C., Stevens, P., Liddement, J., & Huddy, V. (2014). Cognitive remediation therapy for borderline personality disorder: Is it a feasible and acceptable treatment? A pilot study of two single cases. The Cognitive Behaviour Therapist, 7, e12.
Reitan, R. M. (1979). Trail making test: Manual for administration and scoring. South Tucson, AZ: Reitan Neuropsychology Laboratory.
Reitan, R. M., & Wolfson, D. (1993). The halstead–reitan neuropsychological test battery: Theory and clinical interpretation. 2nd ed. Tucson, AZ: Neuropsychology Press.
Ruocco, A. C. (2005). The neuropsychology of borderline personality disorder: A meta-analysis and review.Psychiatry Research, 137(3), 191–202.
Ruocco, A. C., Lam, J., & McMain, S. F. (2014). Subjective cognitive complaints and functional disability in patients with borderline personality disorder and their nonaffected first-degree relatives. Canadian .Journal of Psychiatry, 59(6), 335–344.
Ruocco, A. C., Laporte, L., Russell, J., Guttman, H., & Paris, J. (2012). Response inhibition deficits in unaffected first-degree relatives of patients with borderline personality disorder. Neuropsychology, 26(4),473–482.
Salvi, G., Leese, M., & Slade, M. (2005). Routine use of mental health outcome assessments: Choosing the measure. The British Journal of Psychiatry, 186, 146–152.
Schmahl, C. G., Vermetten, E., Elzinga, B. M., & Douglas Bremner, J. (2003). Magnetic resonance imaging of hippocampal and amygdala volume in women with childhood abuse and borderline personality disorder. Psychiatry Research: Neuroimaging,122(3), 193-198.
Seres, I., Unoka, Z., Bódi, N., Aspán, N., & Kéri, S. (2009). Windgassen, K., (2005), The neuropsychology of borderline personality disorder: Relationship with clinical dimensions and comparison with other personality disorders. Journal of Personality Disorders, 23(6), 555–562.
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society B: Biological Sciences, 298(1089), 199–209.
Skodol, A. E., Gunderson, J. G., Pfohl, B., Widiger, T. A., Livesley, W. J., & Siever, L. J. (2002). The borderline diagnosis I: psychopathology, comorbidity, and personality structure.Biological Psychiatry, 51(12), 936-950.
Stanford, M. S., Mathias, C. W., Dougherty, D. M., Lake, S. L., Anderson, N. E., & Patton, J. H. (2009). Fifty years of the Barratt impulsiveness scale: An update and review. Personality and Individual Differences, 47(5), 385–395.
Stringer, B., van Meijel, B., Eikelenboom, M., Koekkoek, B., M.M Licht, C., Kerkhof, A. J. F. M., . Beekman, A. T. F. (2013). Recurrent suicide attempts in patients with depressive and anxiety disorders: The role of borderline personality traits. Journal of Affective Disorders, 151(1), 23-30.
Tebartz van Elst, L., Hesslinger, B., Thiel, T., Geiger, E., Haegele, K., Lemieux, L., . . . Ebert, D. (2003).Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study. Biological Psychiatry, 54(2), 163-171.
Vita, A., De Peri, L., Barlati, S., Cacciani, P., Deste, G., Poli, R.,…Sacchetti, E. (2011). Effectiveness of different modalities of cognitive remediation on symptomatological, neuropsychological, and functional outcome domains in schizophrenia: A prospective study in a real-world setting. Schizophrenia Research, 133(1–3), 223–231.
Vita, A., Deste, G., De Peri, L., Barlati, S., Poli, R., Cesana, B. M., & Sacchetti, E. (2013). Predictors of cognitive and functional improvement and normalization after cognitive remediation in patients with schizophrenia.Schizophrenia Research, 150(1), 51–57.
Walter, M., Gunderson, J. G., Zanarini, M. C., Sanislow, C. A., Grilo, C. M., McGlashan, T. H.,…Skodol, A. E.(2009). New onsets of substance abuse disorders in borderline personality disorder over 7 years of follow-ups: Findings from the collaborative longitudinal personality disorders study. Addiction, 104 (1), 97–103.
Wing, J. K., Beevor, A. S., Curtis, R. H., Park, S. B., Hadden, S., & Burns, A. (1998). Health of the Nation Outcome Scales (HoNOS). Research and development. The British Journal of Psychiatry, 172, 11–18.
Wykes, T., Huddy, V., Cellard, C., McGurk, S. R., & Czobor, P. (2011). A meta-analysis of cognitive remediation for schizophrenia: Methodology and effect sizes. American Journal of Psychiatry, 168(5), 472–485.
Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry, 155(12), 1733–1739.
Zanarini, M. C., Gunderson, J. G., Frankenburg, F. R., & Chauncey, D. L. (1989). The revised diagnostic interview for borderlines: Discriminating BPD from other Axis II disorders. Journal of Personality Disorders, 3 (1), 10–18.
Zeng, R., Cohen, L. J., Tanis, T., Qizilbash, A., Lopatyuk,Y., Yaseen, Z. S., & Galynker, I. (2015).
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